title: Prevalence of rheumatic heart disease in school children of urban Lahore.
abstract: OBJECTIVE
  To determine the prevalence of rheumatic heart disease (RHD) among school children in urban and semiurban areas of Lahore, Pakistan.
  
  
  METHODS
  A cross-sectional survey of school children aged 5-15 years from 70 schools of urban and semiurban Lahore was carried out by a team of cardiologists. Children were screened by clinical examination and diagnosis confirmed by echocardiography. Sociodemographic data were also collected.
  
  
  RESULTS
  Of 24 980 children screened, 986 (3.9%) had a confirmed cardiac lesion; 546 had RHD, 440 had congenital heart disease. The prevalence of RHD was 21.9/1000 children screened (95% CI 20.1 to 23.7). Their mean (SD) age was 10.7 (2.6) years and the female:male ratio was 1.6:1. Most (92.5%) were unaware of the diagnosis and less than 2% were taking rheumatic prophylaxis. All children belonged to a low socioeconomic group and 67% were undernourished.
  
  
  CONCLUSIONS
  The prevalence of RHD in the urban school population of Lahore is among the highest in the world. The younger age of onset is a special feature and most are unaware of the diagnosis, and hence not receiving life-saving secondary prophylaxis.
authors.affiliation: Department of Paediatric Cardiology, Punjab Institute of Cardiology, Lahore, Pakistan. drmasoodsadiq@hotmail.com
authors.forename: M
authors.initials: M
authors.lastname: Sadiq
authors.forename: K
authors.initials: K
authors.lastname: Islam
authors.forename: R
authors.initials: R
authors.lastname: Abid
authors.forename: F
authors.initials: F
authors.lastname: Latif
authors.forename: A U
authors.initials: AU
authors.lastname: Rehman
authors.forename: A
authors.initials: A
authors.lastname: Waheed
authors.forename: M
authors.initials: M
authors.lastname: Azhar
authors.forename: J S
authors.initials: JS
authors.lastname: Khan
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000453:epidemiology; D008946:Mitral Valve Stenosis / Q000453:epidemiology; D020380:Needs Assessment; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence; D012214:Rheumatic Heart Disease / Q000453:epidemiology*; D012574:Schools; D014504:Urban Health